Paraphilia Essay

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A paraphilia is a disorder usually involving extreme or unusual sexual practices wherein individuals derive intense or exclusive sexual gratification. Both sexual objects and sexual acts may be part of a paraphilia domain. Most individuals experience some form of innocuous sexual fetishes throughout their lives. The explosion of pornography in media infers a willing market of consumers. Sexual fetishes become paraphilic when they have the element of psychological dependence and become the sole element for sexual gratification.


Clinicians have grouped paraphilias into major categories based on their distinct behavior as well as the need for specific intervention in therapies. A partial listing of the more common forms of paraphilia follows:

Fetishism. Refers to the fixation on an object or body part that otherwise is nonsexual in nature. Individuals incorporate the fetish into their sexual activity, may become obsessed with collecting objects, or may compulsively focus on a particular body part.

Transvestism. Most often seen in heterosexual males where they have the need to wear women’s clothing to achieve sexual gratification. This need is not analogous to men wearing women’s clothing for effect (drag queens) or to individuals experiencing gender disorders.

Pedophilia. Individuals who have sexual desires for children. Most often seen in heterosexual males whose victims are prepubescent boys and girls. There are some documented cases of women perpetrators.

Voyeurism. The act of watching people without them knowing, and having sexual gratification from the experience. Most often voyeurs masturbate, usually becoming more excited as the risk of being discovered increases.

Exhibitionism. The act of exposing the genitals to unsuspecting individuals. Exhibitionists derive pleasure from the visible reaction of their victims. These individuals are exclusively male, and like voyeurism, risk of discovery is correlated with intensity of pleasure.

Sadomasochism. Intentionally inflicting pain and control on others (sadism) as well as receiving pain and control from others (masochism) for the purpose of sexual pleasure. These acts may range from the benign to the extreme. Individuals engaging in these acts usually have codified rules for safety.

Frotteurism. The act of rubbing or having full body contact with an individual who is usually nonconsenting. The contact results in sexual pleasure.

Bestiality. Engaging in sexual acts with animals. Specific preference for sexual acts with animals that result in exclusive, repeated events are termed Zoophilia.

Rare Forms of Paraphilia. Apotemnophilia (Acrotomophilia) refers to sexual pleasure involving amputees. Telephone Scatalogia is sexual pleasure from obscene phone calls. Coprophilia is sexual pleasure from contact with feces, and Urophilia is sexual pleasure from contact with urine. Necrophilia involves sexual gratification from viewing or having sex with a corpse.


There is no clear understanding of the causation of paraphilic conditions. Behavioral therapists believe a possible causation is the association of objects, acts, or trauma to young children while they experience some form of sexual excitement or gratification. For example, there are case studies of men who have a female shoe fetish. When hypnotized, the majority of these individuals relate a story of being purposely sexual aroused by an adult female using her feet to rub their genitals when they were children. This approach seems to explain some of the fetishes in individuals; however, other forms of paraphilia appear to have deeper issues of control, trauma, and isolation.

Lifestyle Issues

Clinicians become aware of individuals with a paraphilia due to the obsessive nature of the condition. Either individuals are experiencing profound issues affecting their daily functioning or their behaviors have become publicly inappropriate and they experience legal intervention. Paraphilia may result in an individual’s inability to sustain intimate relationships with others. This result could be because of their sexual preferences being so outside the norm that most people would find their acts offensive. What is more common is individuals with a paraphilia having spent their developing years hiding their desires from others and in their adulthood creating a sexual universe of one, themselves. Many individuals with paraphilias connect with others who have the same sexual desires. The recent advent of the Internet has made this connection much easier as well as international in focus. Law enforcement is confronting these issues with the international trafficking of child pornography by pedophiles.

Clinical Interventions

Occasionally individuals will seek therapy interventions for their paraphilia because of the problems it has created in their lives. Individuals with fetishes who have never shared their desires may get caught by family or friends and pressured into intervention. Sometimes isolation drives individuals to seek help. The trained clinician must help individuals explore the direction of their therapy. In the majority of cases with adults, the paraphilic desires will not be eliminated. Therefore, therapy may be most helpful by getting individuals to accept their paraphilic desires and restructure their lives accordingly. There is some documented success with interventions with children prior to puberty onset, who are displaying possible paraphilic tendencies. There is probably a neurobiological component to the condition in the developing brain involving the creation of neuropathways. This theory is reinforced by the recent success of neuropharmacology. Most research on paraphilia interventions have been done with pedophiles and sexually deviant individuals who run afoul of the law. Traditionally, pharmacological interventions involved decreasing the sex drive and therefore limiting the sexual obsession. Within the last decade, selective serotonin reuptake inhibitors (SSRIs) have achieved some success in helping individuals be relieved of the sexual obsessions. The current strategy for successful intervention involves SSRI’s combined with cognitive behavioral therapy.


  1. Colmen, E., & Miner, M. (2000). Sexual offender treatment: Biopsychosocial perspectives [Special issue]. Journal of Psychology and Human Sexuality, 11(3).
  2. Freund, K., & Kuban, M. (1993). Toward a testable developmental model of pedophilia: The development of erotic age preference. Child Abuse & Neglect, 17,315–324.
  3. Parfitt, A. (2007). Fetishism, transgenderism and the concept of “castration.” Psychoanalytic Psychotherapy,21, 61–89.

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